The Study Of Bone Mineral Density And Bone Quality In Patients With Type 2 Diabetes Mellitus

Objective: The incidence of osteoporosis and fracture in type 2 diabetes mellitus is increasing year by year,which brings heavy economic burden to family and society,and seriously reduces the quality of life.The purpose of this study is to investigate the changes of bone mineral density and bone quality in type 2 diabetic patients.By analyzing and assessing the factors that affect the bone mineral density and trabecular bone score of T2 DM patients,it provides a theoretical basis for the prevention and treatment of osteoporosis and fracture in T2 DM patients.Method: From July 2013 to June 2015,we selected 501 hospitalized patients who underwent dual-energy x-ray absorptiometry in the Nanjing Medical University First Affiliated Hospital.Lumbar spine trabecular bone score(TBS)was measured by the TBS i Nsight software.Bone mineral density(BMD)of the femoral neck,the total hip and the lumber spine was measured using dual-energy x-ray absorptiometry.Analysed the changes of bone mineral density and bone quality in patients with type 2 diabetes mellitus.Further explored the changes in gender,age,BMI,Hb Alc,age of onset,diabetes duration related to lumbar spine bone mineral density and TBS in T2 DM patients.Result: Overall analysed the changes of bone mineral density and bone quality in patients with type 2 diabetes mellitus.Compared with the control group,the lumbar spine BMD and the total hip BMD in T2 DM patients increased significantly,while TBS decreased significantly(P value were 0.002,0.014,0.024 respectively).The BMD of the femoral neck had no change(P value was 0.067).Pearson correlation analysis and Logistic regression analysis were used to analyze the changes in gender,age,BMI,Hb Alc,age of onset,diabetes duration related to lumbar spine bone mineral density and TBS in T2 DM patients.The results showed that gender(female)(r=-0.169,P=0.000)and Hb A1c(r=-0.018,P=0.013)were negatively correlated with bone mineral density in patients with T2 DM,and BMI(r=0.011,P=0.003)was positively correlated with bone mineral density in patients with T2 DM.Age(r=-0.091,P=0.000),gender(female)(r=-0.091,P=0.000),BMI(r=-0.009,P=0.000),Hb A1c(r=-0.011,P=0.007)were negatively correlated with TBS in T2 DM patients.Conclusion: the BMD of the total hip and the lumbar spine in T2 DM patients were significantly higher than those in control group.However,TBS in the T2 DM patients was significantly lower than that in the non diabetic group.Female,Female,older age,high BMI and higer Hb Alc level were independent factors of TBS.Compared with BMD,TBS is the first indicator of fracture risk in T2 DM patients.